Dataset Information

Esophageal Involvement and Determinants of Perception of Esophageal Symptoms Among South Koreans With Systemic Sclerosis.

ABSTRACT: Background/Aims:Our study aims to characterize esophageal motor function; evaluate the relationships among esophagogastroduodenoscopy (EGD), high-resolution manometry (HRM), and 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH); and elucidate the determinants of esophageal symptom perception in South Koreans with systemic sclerosis (SSc). Methods:We reviewed prospectively collected HRM (n = 46), EGD (n = 41), and MII-pH (n = 37) data from 46 consecutive patients with SSc (42 females; mean age 50.1 years) who underwent esophageal tests between June 2013 and September 2018. Results:The most common HRM diagnosis was normal (39.1%), followed by ineffective esophageal motility (23.9%) and absent contractility (21.7%). Erosive esophagitis was observed in 12.2% of total SSc patients, with a higher frequency in patients with absent contractility than those with normal motility (44.5% vs 0.0%, P = 0.01). Pathologic acid exposure was observed in 6 patients (20.0%) and positive symptom association in 18 patients (60.0%) in MII-pH tests of symptomatic patients. The proportion of SSc patients with esophageal symptoms not explained by reflux or mucosal or motor esophageal abnormalities was 33.0%. Conclusions:Esophageal involvement among South Koreans with SSc was characterized by heterogeneous motility patterns, with a higher prevalence of normal motility and lower prevalence of erosive esophagitis. Reflux hypersensitivity or functional heartburn might be partly attributed to the perception of esophageal symptoms in SSc patients who have neither gastroesophageal reflux disease nor esophageal dysmotility.

SUBMITTER: Lee JS

PROVIDER: S-EPMC7547196 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Esophageal Involvement and Determinants of Perception of Esophageal Symptoms Among South Koreans With Systemic Sclerosis.

Lee Joon Seong JS Kim Hyun-Sook HS Moon Jung Rock JR Ryu Tom T Hong Su Jin SJ Cho Young Sin YS Park Junseok J Lee Tae Hee TH

Journal of neurogastroenterology and motility 20200901 4

<h4>Background/aims</h4>Our study aims to characterize esophageal motor function; evaluate the relationships among esophagogastroduodenoscopy (EGD), high-resolution manometry (HRM), and 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH); and elucidate the determinants of esophageal symptom perception in South Koreans with systemic sclerosis (SSc).<h4>Methods</h4>We reviewed prospectively collected HRM (n = 46), EGD (n = 41), and MII-pH (n = 37) data ...[more]

PMID: 32989185

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Project description:BackgroundMany questions have been raised in the ongoing battle against COVID-19: How does the public perceive the COVID-19 prevention campaign as a member of the community?; What made the perception of the experts and the public on COVID-19 change from 'simple' to 'serious' epidemic?; What is the risk perception on health?; and what are the effective messages of the government's campaign about disease prevention? As such, this study aimed to examine the perception of the public about the government's campaign against COVID-19. Moreover, this study investigated the more effective messaging strategies for the campaign through subjective values, thoughts, and attitudes about the information dissemination, which became the basis for the degree of people's participation in the disease prevention campaign. METHOD : In order to investigate the public perception on the campaign messages that are promoted by the government for prevention of COVID-19, this study implemented the Q methodology that studies subjective attributes of humans, unlike existing empirical studies. The Q methodology is an approach that endeavors to discover complex issues in human subjectivity through empirical studies. In order to determine the factors that trigger people's voluntary and active practices and the motivation for disease prevention, the Q methodology is implemented to examine human subjectivity, thoughts, and attitudes. When it comes to the disease prevention campaigns that require strong civic awareness as members of the society, the rationale that induces people to participate in the campaign voluntarily and actively is based on their subjectivities, such as values, thoughts, and thinking. The voluntary awareness and behavior of the public campaign participants are based on their subjective perception about the given message.ResultsIn this study, it was ascertained that there were four different types of perceptions among Koreans on the message of the COVID-19 prevention campaign. The four perceptions are as follows: Type 1 is 'the social threat caused by people with COVID-19 related symptoms;' Type 2 is 'the relational measures through personal hygiene;' Type 3 is 'the dependence on the social system due to the disease;' and Type 4 is 'the avoidance of the symptoms caused by human contact.'ConclusionAs a result of this study, it was possible to draw a correlation between people's perception of the campaign message for COVID-19 prevention and campaign messages. The response method of the campaign message must be differentiated according to the type of people's perception of the disease prevention campaign, and the message development required by stages. The different characteristics of each type are clearly explained by keywords: symptomatic person for Type 1, personal hygiene for Type 2, social system for Type 3, and etiquette for Type 4. Type 1 perceived the messages about symptomatic persons as important to prevent the disease spread in the community whereas Type 2 tried to protect themselves from physical threats by developing proactive prevention through personal hygiene management prior to infection. Type 3 responded actively by relying on social systems, such as medical institutions or management organizations, while Type 4 positively responded to the messages related to etiquette that allowed them to avoid virus infection caused by contact with others.

Project description:BackgroundAcute administration of the oral 5-HT1A receptor agonist buspirone, which is commonly used as an anxiolytic drug, may improve compromised lower esophageal sphincter function. In an open-label trial we assessed the effects of buspirone on esophageal motor function and symptoms in patients with esophageal involvement associated with systemic sclerosis (SSc).MethodsThirty consecutive patients with SSc and symptomatic esophageal involvement, despite treatment with proton pump inhibitors, underwent high resolution manometry and chest computed tomography for assessment of motor function and esophageal dilatation, respectively. Regurgitation, heartburn, dysphagia, and chest pain severity was subjectively scored by visual analog scales. Manometric parameters (primary endpoint) and symptom severity (secondary endpoint) were re-examined after 4-week daily administration of 20 mg buspirone. Other medications remained unchanged.ResultsEight patients did not complete the trial because of buspirone-associated dizziness (n = 2), or nausea (n = 2), or reluctancy to undergo final manometry. In the remaining 22 patients lower esophageal sphincter (LES) resting pressure increased from 7.7 ± 3.9 to 12.2 ± 4.6 mmHg (p = 0.00002) after buspirone administration; other manometric parameters did not change. Statistical analysis revealed negative correlation between individual increases in resting LES pressure and supra-aortic esophageal diameter (r = -0.589, p = 0.017), suggesting a more beneficial effect in patients with less severely affected esophageal function. Heartburn and regurgitation scores decreased at 4 weeks compared to baseline (p = 0.001, and p = 0.022, respectively).ConclusionOur findings warrant more conclusive evaluation with a double-blind controlled study; however, buspirone could potentially be given under observation for objective improvement in all patients with SSc who report reflux symptoms despite undergoing standard treatment.Trial registrationClinicalTrials.gov Identifier: NCT02363478 Registered: 21-02-2014.

Dataset Information

Esophageal Involvement and Determinants of Perception of Esophageal Symptoms Among South Koreans With Systemic Sclerosis.

Publications

Esophageal Involvement and Determinants of Perception of Esophageal Symptoms Among South Koreans With Systemic Sclerosis.

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